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/1111,---AL. .ECTRICAL PERMIT AFLLICATION <br /> _ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 i (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 5209 Evergreen Way Everett WA 98203 <br /> BUILDING AREA(if residential, new construction, remodel, or addition)8,000 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Grocery Outlet Retail Store <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ $6000.00 <br /> 1 <br /> NUMBER OF DEVICES (if low voltage): 40 <br /> FIRE ALARM? 0 YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: Installation of Voice/Data and speakers R <br /> [ 11 <br /> CONTACT INFORMATION <br /> 1 <br /> OWNER NAME: Tod Jackson TENANT NAME(If Commercial): Grocery Outlet <br /> OWNER MAILING ADDRESS: STREET 5209 Evergreen Way <br /> CITY Everett STATE WA Zip 98203 <br /> OWNER PHONE: 510-918-2394 OWNER EMAIL: <br /> CONTRACTOR NAME: SeaCom Cabling Inc i <br /> CONTRACTOR ADDRESS: STREET 3014 Hoyt Ave <br /> CITY Everett STATE WA 71P 98201 <br /> CONTRACTOR PHONE: 425-317-8259 CONTRACTOR EMAIL: rlowery@callseacom.com d <br /> CONTRACTOR LIC.#(REQUIRED): SEACOC1944DO CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 053655 <br /> 711-1 <br /> PRIMARY CONTACT: 0 OWNER ® CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-530-7363 <br /> Randy Lowery CONTACT EMAIL: rlowery@callseacom.com F <br /> AGREEMENT:t hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and i <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> City of Everett Official Use Only <br /> lner/Aute <br /> PERMIT# <br /> /d E I o <br /> Ohorized gent :Ignature Date (Revised 9/23/2016) <br />